In 2020, we kicked off a three-part blog series examining the challenges of EMR interrogation and the best time to interrogate EMRs for clinical trial recruitment. In this third installment, we discuss the method of EMR interrogation for locating and obtaining information to help identify patients for a clinical trial. If healthcare organizations can’t identify the right patients, they often fall short on recruitment goals, which leads to failed trials and missed opportunities for targeted therapy to reach the right patients.

Inteliquet™ believes that EMR recruitment is part of an effective and efficient method for clinical trial recruitment, and the research supports it. In one study, the number of patients enrolled per month doubled after implementing automatic, alert-based EMR screening, with similar numbers of patients screened before and after the implementation.1

Today, we conclude this blog series with a discussion on how clinical research sites can best evaluate the different tools and collaborators available to help facilitate EMR interrogation and leverage this tool to find patients for clinical trials, which is the most challenging and time-consuming element of this process. We’ll close with a brief story that helps to illustrate the results that can be achieved.

What to Evaluate
When looking for tools and partners, there is no one-size-fits-all situation. It is essential to look at a myriad of options and ensure that you understand the uniqueness of your Cancer Center’s workflow and particular processes for finding patients for clinical trials. And remember, technology will not solve all challenges, but it allows your team to put more effort into valuable patient care activities.

When determining how to interrogate your EMRs for patient recruitment, healthcare organizations must consider the following:

  • Technology Tools
    Consider applications designed to help mine, extract, and analyze data from an EMR. The right solution will be able to extract EMR data, better identify eligible patients, and reduce administrative burdens for your team. Such capabilities to take into consideration include:
    • Are these tools freestanding software applications, or do they integrate into an EMR?
    • Can the tool conduct effective pre- or precision screening?
    • Will the tool improve the process of finding data for feasibility studies, cohort analyses, or questionnaires? Will it give you a better understanding of your patient population so you can focus on trials that are the best fit for your unique patients?
    • Does the tool have capabilities for advanced or precision matching, such as Natural Language Processing (NLP), Artificial Intelligence (AI), or other advanced capabilities? These automate the process of searching patient databases and remove the manual element of rummaging through paper patient records. Can you easily access biomarkers and lab data? Ensure your technology can handle structured and unstructured data, such as clinical information from doctor notes.

  • Collaborators
    Collaborators are organizations that provide services and support to help with some aspect of recruitment, including finding patients for trials, providing real-world data, or supplying additional diagnostic information, such as molecular or genomics testing.

  • Hybrid Solutions
    For organizations that have a combination of tools and applications, real-world data provides a more holistic solution that can be customized to meet individual needs. It is also important to see if a partner can do the following:
    • Integrate with your current EMR across several sites or enterprise-wide in the case of an academic center or integrated delivery network (IDN).
    • Access clinically relevant datasets that may be “buried” in an EMR, such as biomarkers and lab data.
    • Develop a pilot program to get clinical staff comfortable with new processes. Partners need to understand your organization’s appetite or budget for new tools or enablers.
    • Seamlessly work within your clinical site’s workflow with minimum disruptions.
    • Help manage this IT project and other IT projects happening in your organization that may compete with a new implementation.

There are many moving parts to implementing a process around EMR interrogation, and the results can be significant.

Cancer Center Improves Recruitment During a Pandemic
Working with one of the largest community oncology practices in Southwestern United States, Inteliquet and the Cancer Center found patients to enroll in complex breast cancer studies, which were at risk of being closed due to lack of enrollment.

The Cancer Center faced challenges with inclusion/exclusion criteria (IE) due to the lack of easy methods within the EMR to determine when patients became metastatic. As a result, the site had difficulty identifying patients with such advanced diseases. 

Inteliquet implemented its OncWeb™ platform at the Cancer Center, including a clinical trial matching application called Inteliscreen™. This clinical trial application assists users with patient identification and matching efforts, including pre-screening, tracking, reporting, and communication.

Inteliquet’s dedicated clinical engagement specialists, who are experienced clinical research professionals and experts in the OncWeb platform, partnered with the clinical research coordinator and research site manager to assist with pre-screening efforts.

The Inteliscreen application identified potential candidates, placing a total of twenty patients on a user-curated “Watch List.” The list allowed clinical staff to easily follow patients who may soon be eligible for a trial. Once patients were on the Watch List, the team followed and monitored their disease progression more closely. The staff would then follow up when patients returned for appointments.  

One patient returned to the clinic in late 2019 after a biopsy confirmed that the patient could begin participation in the trial. As of the date of this case study, two breast cancer patients have enrolled, one in each study, with at least three more in the pipeline being monitored for progression so they can be moved to the study as soon as possible. 

Another seven patients remain on the Inteliquet Watch List. They are being monitored for progression so they can be moved to the study should their conditions progress.

Thanks to the work of Inteliquet’s OncWeb clinical trial software platform and dedicated clinical engagement team, the Cancer Center continues to find patients for possible enrollment, and the studies remain open for both patient screening and accrual.

How we can help
The use case outlined above is one example of how Inteliquet is the best option for Cancer Centers in community practices, academic centers, and IDNs. We strive to be the partner that:

  • Meets your organization where it is now and supports you in the future.
  • Offers a comprehensive set of tools for all users.
  • Supports specific goals of the organization.
  • Brings innovative, highly capable data and search technologies, such as NLP and AI-powered tools to improve the patient-matching process.

To find out more of what we can do—and how we can help you find the patients you need—please contact us here.

1Lai YS, Afseth JD. A review of the impact of utilising electronic medical records for clinical research recruitment. Clin Trials. 2019;16(2):194-203.